Fungal Infections

Fungal Infections

Dermoscopy is the non-invasive examination of the skin using skin surface microscopy. It is used to evaluate pigmented skin lesions and is a particularly useful tool for the early diagnosis of malignant melanoma. Dermoscopy has been shown to improve the diagnostic accuracy of melanoma by up to 49% if used by experts (Kittler et al. 2002). There is recent interest in using it to diagnose cutaneous fungal infections of many types, including tinea capitis, pityriasis versicolor, onychomycosis and many other unusual fungal diseases. For a recent review, see Erruchetti & Stinco (2016).

The gold standard technical equipment in this context is an epi-illuminescent stereo microscope, with an attached high-end digital camera and a computer station with typically, proprietary image storing software which can be connected to an electronic health record (e.g. the FotoFinder Dermoscope Studio). This type of total dermoscopy system however, is very expensive and not widely accessible. Technological advances have sought to improve on this set up, with specially designed portable devices now commercially available. Such devices include:

This rise in availability of portable devices has allowed patients and primary care physicians access to dermatologists in medically underserved and remote communities. Known as teledermoscopy, devices attached to phones with cameras and internet capabilities make it possible to send digital images of skin lesions with relevant clinical information to a dermatologist for his/her opinion. In a recent study, the diagnostic accuracy of teledermoscopy was tested using the FotoFinder Handyscope, attached to an iPhone 4, running the iDoc24 app. Teledermoscopy was found to be comparable to a Face-to-Face dermatologist appointment (Borve et al. 2013).